56. Lymphoreticular tumours. Classification. Hodgkin’s lymphomas. Clinical signs, methods of diagnosis, differen>al diagnosis. Treatment

what is Hodgkin lymphoma?

malignant proliferation of Reed-Sternberg (RS) cells

most curable form of cancer

begins in upper body lymph nodes - mostly in cervical lymph nodes

how does Hodgkin lymphoma spread?

spreads through lymph vessels in a stepwise fashion from lymph node to lymph node

Hodgkin lymphoma common sites include

chest

neck

under arms

what are the 2 types of Hodgkin lymphomas based on histopathology?

1. classic Hodgkins- Reed Sternberg cells can be seen

2. nodular lymphocyte predominant- popcorn cells (variants of Reed Sternberg cells)

what are the risk factors of Hodgkins lymphoma?

- age (15-30 and >55) biphasic

- family history

- men

- EBV (those with past EBV increased likelihood)

- weak immunity (HIV/AIDS)

what is the most common symptom of Hodgkins lymphoma?

enlargment of one or more lymph node causing bump/lump under skin that isn’t painful

what are the minor symptoms of Hodgkins lymphoma?

night sweats - require new bed sheets/clothes

weight loss + loss of appetite

fever

severe and constant itching

persistent fatigue

enlarged nodes

increased sensitivity to alcohol / pain in nodes after drinking

diagnosis of lymphoma

physical exam - enlarged lymph nodes

blood tests - wbc

lymph node biopsy - removal of whole lymph node

bone marrow biopsy

staging of lymphoma

stage 1 - in one lymph node or organ

stge 2 - in two lymph node regions / invaded 1 organ nearby to affectedd lymph node cancer is limited to above/below diaphgram

stage 3- involves lymph nodes above + below diaphgram

stage 4 - cancer cells in several portions of one or more organs/tissues affects body parts liver lungs bones

difference of A and B

A means pt suffers no significant symptoms as a result of cancer

B means pt suffers significant symptoms like night sweats unintended weight loss

What is the IPI?

index based on 5 factors to determine prognosis of patient

factors include

• age

• stage

• organs affected

• functionality of patient

• serum LDH levels

IPI values

treatment for lymphoma patients in stage 1+2 ?

radiation therapy

treatment for asymptomatic lymphoma patients in stage 3+4?

watch and wait

chemotherapy

treatment for symptomatic/transformed nhl lymphoma patients in stage 3+4?

single or combination therapy